Differential Diagnosis

Stridor in a child can be acute or chronic. Table 1 shows the common causes of acute and chronic stridor. The diagnosis and treatment of the causes of chronic stridor are outside the scope of this module.

Table 1 Common causes of acute and chronic stridor
Acute Stridor Chronic Stridor
Excluding croup, the most likely causes of acute stridor are:

  • Foreign body aspiration (see next page)
  • Angioedema
  • Abscess (peri-tonsillar or parapharngeal)
  • Epiglottitis
  • Bacterial tracheitis
  • Laryngomalacia (75% of cases of chronic stridor. It is due to a congenital abnormality of the laryngeal cartilage causing it to collapse on inspiration. 99% resolves spontaneously by the age of two years)
  • Vocal cord dysfunction
  • Subglottic stenosis
  • Laryngeal webs
  • Laryngeal cysts
  • Laryngeal heamangioma
  • Tracheamalacia
  • Tracheal stenosis


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